以血清碱性磷酸酶显著升高为主要临床特点的合并骨髓播散的胃癌一例  

A case of occult malignancies with disseminated carcinomatosis of the bone marrow presenting with isolated elevation of serum alkaline phosphatase

作　　者：杨莹莹 袁涛 李清霖 毛歆歆 夏维波 朱惠娟 Yang Yingying;Yuan Tao;Li Qinglin;Mao Xinxin;Xia Weibo;Zhu Huijuan(Key Laboratory of Endocrinology of National Health Commission,Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内分泌科,国家卫生健康委员会内分泌重点实验室,100730

出　　处：《中华内分泌代谢杂志》2021年第11期1013-1016,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：中国医学科学院中央级公益性科研院所基本业务费(2018PT32001)。

摘　　要：血清碱性磷酸酶(alkaline phosphatase,ALP)是很常见的化验指标,在临床上被广泛应用,异常ALP水平有助于对多种疾病进行鉴别诊断。本文报道1例主要以ALP显著升高为主要临床特点的胃腺癌伴骨髓播散的病例。值得注意的是该病例临床症状并不典型,且影像学检查均未提示肿瘤,并导致了该病例开始被误诊为Paget骨病。本文通过该例报道提醒临床医师注意,仅表现为单纯ALP升高的骨骼恶性肿瘤患者因症状不典型可能会被误诊。The measurement of serum alkaline phosphatase(ALP)levels has been widely used in the clinical setting.However,isolated elevation of serum ALP levels is also commonly seen and needs to be extensiuely evaluated Herein,we present a case of gastric adenocarcinoma with disseminated carcinomatosis of the bone marrow(DCBM).In this case,isolated elevation of serum ALP levels was the only clinical manifestation with no other notable symptom.Additionally,imaging studies including whole body computed tomography(CT)and positron emission tomography-CT(PET-CT)were all negative,which resulted in the misdiagnosis of Paget′s disease of bone initially.This highlights that malignancies involving bones presenting with isolated elevation of serum ALP levels might be misdiagnosed in asymptomatic individuals.

关 键 词：碱性磷酸酶 PAGET骨病 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]